One in three Hispanic/Latino adults with diabetes had retinopathy, and hypertension tracked with sight-threatening disease

Design

Cross-sectional population-based study

Population

1,224 Hispanic/Latino adults aged ≥40 with diabetes, Chicago and Miami

Primary outcome

Age-standardised prevalence of retinopathy; association with CVD risk factors

Effect

Any DR 34.7% (29.2 to 40.2); hypertension OR 3.16 for any DR, 2.86 for vision-threatening DR

A cross-sectional analysis in Ophthalmology, published on 9 October, examined 1,224 Hispanic/Latino adults with diabetes aged 40 and over in Chicago and Miami with centrally graded ultra-widefield retinal imaging.

Age-standardised prevalence of any retinopathy was 34.7% (95% CI 29.2 to 40.2), higher in men (41.8%) than women (27.2%), and varying widely by background. Hypertension was associated with any retinopathy (OR 3.16) and with vision-threatening retinopathy (OR 2.86). Cardiovascular risk factors clustered heavily.

The population is not Indian, but the message transfers: in people with diabetes, blood pressure is linked to retinal risk, and the retina screen is a chance to address cardiovascular risk as a whole.

• Check blood pressure at diabetic eye screening visits and refer for control when raised.
• Expect higher retinopathy rates in men with diabetes.
• Treat cardiovascular risk factors together; they clustered in most patients.
• Use retinal findings to reinforce the case for blood pressure control with patients.

Why it matters

Eye screening is often the most regular contact a person with diabetes has, and it can do more than grade the retina.

Don't overread it

Cross-sectional; it shows association, not that lowering blood pressure prevents retinopathy in this population.

The statistics, in plain English

An odds ratio of 3.16 for hypertension means about three times the odds of retinopathy after adjustment. The interval for vision-threatening disease (1.05 to 7.79) is wide, so the strength of that link is uncertain.

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